Jonathan Song, OMD, MD, PHD, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

232 Issued in WI

Practice address

6255 University Ave
Suite 202
Middleton, WI 53562-3485

Phone

(608) 238-3333

Fax

(608) 238-3374

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Madison Integrative Medicine Alliance, Inc

  • Acupuncturist
  • Middleton, WI
  • NPI 1366568412
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336265495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 UNIVERSITY AVE",
            "address_2": "SUITE 202",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623485",
            "telephone_number": "608-238-3333",
            "fax_number": "608-238-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6255 UNIVERSITY AVE",
            "address_2": "SUITE 202",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535623485",
            "telephone_number": "608-238-3333",
            "fax_number": "608-238-3374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "OMD, MD, PHD, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "WI",
            "license": "232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Slick, DPT
• Jana M Slinger, PA
• Diana L Slocum
• Jeffrey J. Smarrella, M.D.
• Smart Scan Medical Imaging - Madison, LLC
• Leaf Ye Song, OMD, MS, LAC
• Kimberly Anne Sorenson, CPO
• Gustavo Alexander Sosa
• Jose Rafael Soto
• Stephanie Spence

• Acupuncturist in Middleton, WI
• Providers in Middleton, WI by specialty
• Acupuncturist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.